Implementation of the Three-Tiered Prevention Approach

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Tary J. Tobin, Celeste Rossetto Dickey
University of Oregon
Center on PBIS
Directed by George Sugai and Robert H. Horner
Coordination, Consultation, and Evaluation (CCE) Center
at the University of Wisconsin
Will have case studies of a variety of 3 tiered models
of school wide interventions, some academic, some
behavioral, some both academic and behavioral.
1.
2.
3.
4.
5.
6.
7.
What is a 3 tiered approach to School Wide
Positive Behavior Support (SWPBS)?
What’s the background for this study?
How was this school selected?
Interventions at this school
Outcomes for students
Conclusions & Practical Implications
Discussion & questions
Fifth International Conference on
Positive Behavior Support Chicago, IL
3/27/2008
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~5%
~15%
Primary Prevention:
School-/ClassroomWide Systems for
All Students,
Staff, & Settings
Tertiary Prevention:
Specialized
Individualized
Systems for Students
with High-Risk Behavior
Secondary Prevention:
Specialized Group
Systems for Students
with At-Risk Behavior
http://pbis.org
~80% of Students
Fifth International Conference on
Positive Behavior Support Chicago, IL
3/27/2008
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Primary
Prevention
• Universal Interventions
Secondary
Prevention
• Targeted Interventions
Tertiary
Prevention
• Intensive, Individualized Interventions
• All students in the school
• Students at risk for behavior
problems
• Students with serious or chronic
behavior problems
Fifth International Conference on
Positive Behavior Support Chicago, IL
3/27/2008
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

Primary Prevention: Universal interventions
for all students
Extra support for some students:
◦ Secondary Prevention: Targeted interventions for
students at heightened risk for behavior problems
◦ Tertiary Prevention: Intensive interventions for
individual students
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Positive Behavior Support Chicago, IL
3/27/2008
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
Behavioral expectations are
◦ defined,
◦ taught,
◦ and encouraged.
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Positive Behavior Support Chicago, IL
3/27/2008
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Defining behavioral expectations.
Using a range of positive and negative examples to
teach all students and staff members.
 Opportunities to practice.
 Being rewarded and positively acknowledged when
they use them.
 Having most contacts between teachers and
students be prosocial (positive and preventive)
rather than corrective and punishing.
 Using data to make decisions and to build action
plans.
The universal intervention is systematically
coordinated with targeted and intensive
individualized interventions.


(Sugai & Horner, 2001; Sugai et al., 2000)
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Positive Behavior Support Chicago, IL
3/27/2008
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 Behavior
Education Program, also
known as “Check In, Check Out”
(CICO)
(Crone, Horner, & Hawken, 2004)
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Positive Behavior Support Chicago, IL
3/27/2008
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Examples:
 First Step to Success
 Behavior Education Program, also
known as “Check In, Check Out”
(CICO)


Crone, Horner, & Hawken, 2004;
Sugai, Horner, Lewis-Palmer, & Todd, 2005
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Student
 checks in at beginning of day with an adult at the
school;
 gives assessment form to teacher at beginning of
each period; [Cue for teacher to monitor]
 receives feedback on behavior at end of each class
period;
 checks out at end of day with the same adult;
 takes CICO form home and gets it signed by parent.
Team assesses % of points earned daily, and
adjusts intervention weekly. (e.g., add selfmonitoring)
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Positive Behavior Support Chicago, IL
3/27/2008
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
Functional Behavioral Assessment
(FBA)
◦ Competing Behavior Pathway
(O’Neill et al., 1997)


Behavior Support Plan based on the
FBA
(Crone & Horner, 2003)
Fifth International Conference on
Positive Behavior Support Chicago, IL
3/27/2008
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 Functional
Behavioral Assessment
(FBA)
 Behavior Support Plan based on
the FBA
(Crone & Horner, 2003)
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

Teachers decide who needs extra support,
using Response to Intervention (RtI) logic.
Barkley has a strong support system for the
teachers, including:
◦ Action Plans from School-wide PBS Team
◦ School Wide Information System (SWIS)
◦ Teacher Assistance Team for Academic & Prereferral Suggestions
◦ District & School Teams Focused on Behavior
Support for Individual Students
◦ Student Study Team for Special Education
Referrals and On-going Help
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Positive Behavior Support Chicago, IL
3/27/2008
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Bethel School District
Enrollment: 6,300 students
Staff: 650
Elementary Schools
K-8 Schools
Middle Schools
High Schools
Clear Lake
Meadow View
Cascade
Willamette
Danebo
Prairie Mountain
Shasta
Kalapuya (Alt)
Fairfield
Irving
Malabon

6,300 Students, 650 Staff

Suburban/Rural District


Free/Reduced Lunch (27-75%)
District Average 48%
Mobility Rate (8%-29%)
1988
2008
Funding
Visibility
Political
Support
Leadership Team
Active Coordination
Training
Coaching
Evaluation
Local School Teams/Demonstrations






Commitment to scientifically-based
practices
Approach based on principles of effective
instruction
Data-based decision making
Regular screening
Universal core curriculum
Continuum of support beyond universal
systems

Three tier model

Research/University Partnerships
◦ PBS
◦ Reading K-9
◦ Mathematics K-12
◦
◦
◦
◦
PBS – Sugai, Horner, Anderson & Colvin
Reading – Kame’enui, Simmons, Good & Harn
RTI – Fuchs & Harn
Mathematics – Chard, Jungjohann, Baker,
Ketterlin-Geller, Tindal & Doabler

PBS District Leadership Team since 2000

PBS District Coordinator since 2000

Elementary, Middle and K-8 schools
Monthly School PBS Team Meetings


Quarterly District PBS Team Trainings

Quarterly PBS Facilitator Meetings
PBS Schoolwide Team – meets monthly
 BISSC Team – meets 1-2x monthly
(now called IPBS Team)
 TAT (Teacher Assistance Team) meet
about individual students to develop
plans

Braun, Kowalko & Smith, 2007
Braun, Kowalko & Smith, 2007
Braun, Kowalko & Smith, 2007
Braun, Kowalko & Smith, 2007
Braun, Kowalko & Smith, 2007
Braun, Kowalko & Smith, 2007
Behavior Tracking Study Schools
Office Discipline Referrals Per 100 Students
90
80
70
60
2001-02
50
2002-03
2003-04
40
2004-05
2005-06
30
20
10
0
School 1
School 2
School 3
School 4
School Average



Universal: PBS School-wide Interventions
Targeted: Check In Check Out, Social Skills
Groups, Counseling Groups, Breakfast
Buddies, Recess Club, etc.
Individual: FBA/BSP, Individualized support,
Family and Community involvement

Staff Member refers student to Teacher
Assistance Team
◦ Team includes Teacher, Previous Teacher,
Counselor, Special Educator, Administrator, and
others
◦ Decisions about intervention & follow up scheduled
Monthly meeting to review students receiving
targeted and individual interventions
 Team includes: Special Educator, Counselor,
Administrator, District Level Liaison (School
Psychologist or Behavior Specialist)
 Decisions about plan revisions, follow up TAT
or moving from Targeted to Intensive
interventions
* Now called IPBS (Individual PBS Team)




Behavior and/or Reading Research Centers
(Oregon, Texas, Nebraska, North Carolina,
Kansas)
United States Office of Special Education
Programs
Coordination, Consultation, and Evaluation
Center of the University of Wisconsin.
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 “To
expand the conceptual and
empirical knowledge about
behavior support
 for students who exhibit or are
at-risk of developing serious
problem behaviors that lead to
later discipline problems” (Sugai &
Horner, 2003).
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Positive Behavior Support Chicago, IL
3/27/2008
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
Systematic Screening for Behavior Disorders
(SSBD, Walker & Severson, 1990) or Early
Screening Project (ESP, Walker, Severson, & Feil,
1995).


Social Skills Rating System (SSRS, Gresham &
Elliott, 1990).
Office Discipline Referrals
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


Identified by scores on the Adaptive and/or
Maladaptive behavior scales of the SSBS / ESP
based on norms by grade level and gender
At or above 70th percentile on internalizing
or externalizing behavior problems was the
criteria for being in the Tracking Sample.
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Positive Behavior Support Chicago, IL
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

Grade 1: Systematic Screening for Behavior
Disorders (SSBD, Walker & Severson, 1990)
Kindergarten: Early Screening Project
(ESP, Walker, Severson, & Feil, 1995)
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Positive Behavior Support Chicago, IL
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




Gains other children’s attention in an
appropriate manner.
Expresses anger appropriately (without
becoming violent or destructive)
Gains teacher attention in appropriate ways.
Participates well in group activities.
Initiates positive social contact with peers.
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




Behaves inappropriately in class when
directed (e.g., shouts, defies teacher).
Creates disturbance during class activities
(noisy, bothers other children, etc.)
Tests or challenges teacher’s limits/rules
Pouts or sulks
Is overly affectionate with others (touching,
hugging, kissing, hanging on, etc.)
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ANOVA
Extra Support
Between Groups
Within Groups
Total
Sum of
Squares
12.851
9.567
22.418
df
34
56
90
Mean Square
.378
.171
F
2.212
Sig.
.004
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Positive Behavior Support Chicago, IL
3/27/2008
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

Identified by scoring in the 30% percentile for
“at-risk” for behavior disorders
on the Adaptive and/or Maladaptive behavior
scales
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Positive Behavior Support Chicago, IL
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


Screening done to select new students for the
Tracking Sample each year, while still
following and monitoring progress of each
cohort over the years, up to 3rd grade
2002-2003: Cohort A starts
2003-2004: Cohort B starts
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Positive Behavior Support Chicago, IL
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
Grade-based Percentile for
Problem Behaviors as rated by teachers on
the Social Skills Rating System (SSRS,
Gresham & Elliott, 1990)
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Positive Behavior Support Chicago, IL
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1. Social Skills [Similar to the Adaptive
behaviors on the SSBD]
2. Problem Behavior [Similar to the Maladaptive
behaviors on the SSBD]
3. Academic Competence (includes reading,
math, motivation, intellectual function, etc.)
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1. Cooperation, 2. Assertion, 3. Self-Control (the Social
Skills)
4. Externalizing, 5. Internalizing, 6. Hyperactive Behaviors
(the Problem Behaviors)
7. Academic Competence (same as the main Academic
Competence Scale)
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


Using the Oregon Behavior Research Center’s
3-tiered approach to SWPBS
With fidelity
Good outcomes for students in the Tracking
Sample Study
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Positive Behavior Support Chicago, IL
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


Using the 3-tiered approach to SWPBS
With fidelity
Good outcomes for students in the Tracking
Sample Study
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Positive Behavior Support Chicago, IL
3/27/2008
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
School-wide Evaluation Tool (SET)
(Horner et al., 2004)

Individual Student Systems Evaluation
Tool (I-SSET)
(Lewis-Palmer, Todd, Horner, Sugai, & Sampson, 2005)
Fifth International Conference on
Positive Behavior Support Chicago, IL
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SET Total Scores Over Time at this School
100
90
Total SET Score
80
70
60
50
40
30
20
10
0
C
00-01
01-02
02-03
03-04
04-05
68
88
91
96
100
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Positive Behavior Support Chicago, IL
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
Trained and Skilled Data Collectors
◦ Interviews
 Administrator
 Behavior Specialist
 Behavior Support Team & School Staff
◦ Examination of Records
 Functional Behavioral Assessments (FBAs)
 Behavior Support Plans based on FBAs
 Policies & Team meeting minutes

Produces 3 Scores
◦ Foundations
◦ Targeted Systems
◦ Individual Systems
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Positive Behavior Support Chicago, IL
3/27/2008
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Improvement on I-SSET at this School
Foundation
100
90
80
Percent of Possible Points
70
60
50
40
30
20
10
0
2003-2004
2004-2005
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2005-2006
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40.00%
28.30%
30.00%
22.43%
Percent Change over 2 Years
20.00%
10.00%
5.85%
0.00%
Foundation Change
-10.00%
Targeted Change
Intensive Change
Fighting /
Aggression ODRs
Change
-20.00%
-30.00%
-40.00%
-41.18%
-50.00%
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100
P
r
o
b
l
e
m
B
e
h
.
P
e
r
c
e
n
t
i
l
e
Outcomes for Tracking Sample Students:
Average SSRS Problem Behavior Percentile Score by School
Can you guess which school was selected?
90
80
E
F
G
A
B
C
D
70
60
50
40
30
20
10
0
Time 1
Time 2
Time 3
Time 4
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Positive Behavior Support Chicago, IL
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

For the school
For the students
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Positive Behavior Support Chicago, IL
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




“Mid-size Central City” in the Northwestern part of
the United States.
Enrollment ranges from about 325 to 345 students,
in Grades K-5.
Ethnicity/racial groups:
◦ The percentage of White (Non-Hispanic) students ranged
from 89% to 78%.
◦ Latino or Hispanic students, increasing, currently about 12%
◦ African American (Non-Hispanic), 1% to 4%
◦ Asian or Pacific Islander, 1% to 6%
◦ American Indian or Alaska Native, 2% to 5%.
65% to 70% free or reduced lunch
Title 1 school.
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
Barkley uses the school-wide systems of
support that constitute PBS as described in
the Positive Behavior Support Team Training
Manual (Sugai, Horner, Lewis-Palmer, & Todd,
2005, available online at
http://pbismanual.uoecs.org).
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3/27/2008
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Primary prevention provided for ALL
students
 14 (74%) of students who met criteria
receiving no additional intervention.

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Positive Behavior Support Chicago, IL
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5 of the 19 students received the
targeted intervention, Check in /
Check out (CICO) in addition to the
universal intervention
 One student received a tertiary level
intervention, an intensive,
individualized, behavioral intervention
based on a functional behavioral
assessment, also known as “functionbased support.”

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Positive Behavior Support Chicago, IL
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
2002-2003:
◦ Kindergarten (AK)
◦ 1st Graders (A1)

2003-2004
◦ Kindergarten (BK)

2004-2005 & 2005-2006
◦ Students move up through the grades (or move
away)

More cohorts in the full study:
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Grade Levels of Cohorts by Project Year
Cohorts: AK, A1, BK, B1, CK
4
Grade Level (0=K, 1 = 1st, etc.)
1 = None
3
3
4
3
CK
2
2
2
2
B1
BK
A1
AK
1
1
1
1
0
0
0
0
Spring 0203
Spring 0304
Spring 0405
1
Spring 0506
Project Years 1 through 4
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

For 19 Barkley students who were in the
Tracking Sample Study for at least two
years and had no missing data on key
measures, compared their first to last
year in the study.
On average, dropped from 86th to 59th
percentile on the SSRS problem behavior
scale, which includes both internalizing
and externalizing behavior problems.
Fifth International Conference on
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3/27/2008
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Comparison of Averages on Grade-based Percentiles for Problem Behavior by Level of
Intervention
100.00
90.00
80.00
70.00
Percentile
60.00
Primary Only
50.00
Primary Plus
40.00
30.00
20.00
10.00
0.00
TIME 1
TIME 2
TIME 3
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Positive Behavior Support Chicago, IL
3/27/2008
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Primary Only Tracking Sample Students at Barkley:
Grade-based Percentiles for Problem Behavior
100
90
80
70
Jacob
Percentile
60
Mark
Amy
50
Sara
Alyssa
Mack
40
Lacey
30
20
10
0
TIME 1
TIME 2
Average (SD): Time 1 = 75 (23),
TIME 3
Time 2 = 30 (31),
Time 3 = 29 (29)
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3/27/2008
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Students Receiving Primary Plus Targeted and/or Individualized Support During at Least One
Year: Grade-based Percentiles for Problem Behavior
100
90
80
Benjamin
70
Lori
Ryan
Percentile
60
Aaron
Aalisha
50
Gabe
Isabella
40
Linda
Andy
30
Carl
20
10
0
TIME 1
TIME 2
Average (SD): Time 1 = 91 (7),
TIME 3
Time 2 = 62 (29),
Time 3 = 72 (34)
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Positive Behavior Support Chicago, IL
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Cohort AK: Social Skills Rating Scale's
Problem Behavior Grade-based Percentiles
2003-2004 to 2005-2006
100
90
SSRS %ile Problem Behavior Scale
80
70
Lacey
60
Andy
50
Mabel
Carl
40
Emily
30
20
10
0
Time 1
Time 2
Time 3
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Time 4
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Cohort AK: Office Discipline Referrals (ODRs) from 2002-2003 to 2005-2006
3
2
Number of ODRs
1
0
Lacey
Andy
Mabel
Carl
Emily
Time 1
0
0
0
0
0
Time 2
0
3
0
0
Time 3
0
0
0
0
Time 4
0
0
0
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Cohort A1: Social Skills Rating Scale's
Problem Behavior Grade-based Percentiles
2003-2004 to 2005-2006
100
90
SSRS %ile Problem Behavior Scale
80
70
Aaron
Aalisha
60
Gabe
Eamon
50
Sabastian
Mack
40
Isabella
Linda
30
20
10
0
Time 1
Time 2
Time 3
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Time 4
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Cohort A1: Office Discipline Referrals (ODRs) from 2002-2003 to 2005-2006
6
5
4
Number of ODRs 3
2
1
0
Aaron
Aalisha
Gabe
Eamon
Time 1
2
1
1
Time 2
6
4
0
0
Time 3
0
4
3
3
Time 4
6
0
2
Sabastian
Mack
Isabella
Linda
3
0
0
0
0
1
0
0
0
0
4
0
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Cohort BK: Social Skills Rating Scale's
Problem Behavior Grade-based Percentiles
2003-2004 to 2005-2006
100
90
Jacob
SSRS %ile Problem Behavior Scale
80
Danny
70
Benjamin
Lori
60
Mark
Scott
50
Amy
Sara
40
Amber
Tyler
30
Alyssa
20
Ryan
10
0
Time 1
Time 2
Time 3
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Cohort BK: Office Discipline Referrals (ODRs) from 2003-2004 to 2005-2006
2
Number of ODRs 1
0
Jacob
Danny
Benjami
n
Lori
Mark
Scott
Amy
Sara
Amber
Tyler
Alyssa
Ryan
Time 1
0
0
0
0
0
0
0
0
0
0
0
0
Time 2
0
2
1
0
0
0
0
1
0
0
Time 3
0
1
0
0
0
0
0
0
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Cohort AK: Prevention Levels from 2002-2003 to 2005-2006
3
2
1 = Primary Only
2 = Primary + Secondary
3 = Primary + Tertiary
1
0
Lacey
Andy
Time 1
1
2
Time 2
1
3
1
2
Time 3
1
3
1
1
Time 4
Mabel
Carl
Emily
1
1
1
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Cohort A1: Prevention Levels from 2002-2003 to 2005-2006
2
1 = Primary Only,
2 = Primary Plus 1
Secondary
0
Jacob
Danny
Benjami
n
Lori
Mark
Scott
Amy
Sara
Amber
Tyler
Alyssa
Ryan
Time 1
1
1
1
1
1
1
1
1
1
1
1
2
Time 2
1
2
2
2
1
1
1
2
1
2
Time 3
1
2
1
1
1
2
1
1
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Cohort BK: Prevention Levels from 2003-2004 to 2005-2006
2
1 = Primary Only, Primary
1
Plus Secondary
0
Jacob
Danny
Benjami
n
Lori
Mark
Scott
Amy
Sara
Amber
Tyler
Alyssa
Ryan
Time 1
1
1
1
1
1
1
1
1
1
1
1
2
Time 2
1
2
2
2
1
1
1
2
1
2
Time 3
1
2
1
1
1
1
1
2
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


The primary intervention of PBS is sufficient
behavioral support for many young children
even when identified by the SSBD/ESP.
Over time, the school improved its capacity to
provide the secondary (CICO) & tertiary
(function-based individualized support)
interventions.
Externalizers were more likely to receive extra
support than Internalizers.
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

When School-wide Positive Behavior Support is well
implemented, as it was in this school, the universal
intervention (Primary Prevention) is effective and
efficient behavioral support for many young
children who are identified as “at risk” for
externalizing or internalizing behaviors.
Students with serious behavior problems typically
benefit from extra support (Secondary or Tertiary
Prevention), such as Check In / Check Out and/or
Function-based Support, especially if it is provided
consistently over time while self-management
skills are developing.
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Benazzi, L., Horner, R. H. (2006). Effects of behavior support teams composition on
the technical adequacy and contextual fit of behavior support plans. The Journal of
Special Education, 40, 160-170.
Condon, K. A., & Tobin, T. J. (2001). Using electronic and other new ways to help
students improve their behavior. Teaching Exceptional Children, 34(1), 44-51.
Crone, D. A., & Horner, R. H. (2003). Building positive behavior support systems in
schools: Functional behavioral assessment. New York: Guilford.
Crone, D. A., Horner, R. H., & Hawken, L. S. (2003). Responding to problem behavior
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